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Predictors of loss to follow-up among adult tuberculosis patients in Southern Ethiopia : a retrospective follow-up study.

Watumo, Desta ; Merid Mengesha, Melkamu LU orcid ; Gobena, Tesfaye ; Gebremichael, Mathewos Alemu and Jerene, Degu LU (2022) In BMC Public Health 22.
Abstract
Background

Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a major public health problem as patients can be infectious and also may develop a multi-drug resistant TB (MDR-TB). The study aimed to assess whether LTFU differs by the distance TB patients travelled to receive care from the nearest health facility.
Methods

A total of 402 patient cards of TB patients who received care were reviewed from March 1–30, 2020. The Kaplan-Meir curve with the Log-rank test was used to compare differences in LTFU by the distance travelled to reach to the nearest health facility for TB care. The Cox proportional hazard regression model was used to identify predictors. All statistical tests are declared... (More)
Background

Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a major public health problem as patients can be infectious and also may develop a multi-drug resistant TB (MDR-TB). The study aimed to assess whether LTFU differs by the distance TB patients travelled to receive care from the nearest health facility.
Methods

A total of 402 patient cards of TB patients who received care were reviewed from March 1–30, 2020. The Kaplan-Meir curve with the Log-rank test was used to compare differences in LTFU by the distance travelled to reach to the nearest health facility for TB care. The Cox proportional hazard regression model was used to identify predictors. All statistical tests are declared significant at a p-valueResults

A total of 37 patients were LTFU with the incidence rate of 11.26 per 1000 person-months of observations (PMOs) (95% CI: 8.15–15.53). The incidence rate ratio was 12.19 (95% CI: 5.01–35.73) among the groups compared (those who travelled 10 km or more versus those who travelled less than 10 km). Age ≥ 45 years (aHR = 7.71, 95% CI: 1.72, 34.50), educational status (primary schooling, aHR = 3.54, 95% CI: 1.49, 8.40; secondary schooling, aHR = 2.75, 95% CI: 1.08, 7.03), lack of family support (aHR = 2.80, 95% CI: 1.27, 6.19), nutritional support (aHR = 3.40, 95% CI:1.68, 6.89), ≥ 10 km distance to travel to a health facility (aHR = 6.06, 95% CI: 2.33, 15.81) had significantly predicted LTFU from TB treatment and care.
Conclusions

LTFU from adult TB care and treatment was 12 times higher among those who travelled ≥10 km to reach a health facility compared to those who travelled less. To retain adult TB patients in care and ensure appropriate treatment, health professionals and other stakeholders should give due attention to the factors that drive LTFU. We suggest identifying concerns of older patients at admission and those who travel long distance and establish social support platforms that could help people to complete TB treatment. (Less)
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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Loss to follow-up, Distance to health facility, Adults, Tuberculosis, Southern Ethiopia
in
BMC Public Health
volume
22
article number
976
pages
12 pages
publisher
BioMed Central (BMC)
external identifiers
  • pmid:35568853
  • scopus:85130054779
ISSN
1471-2458
DOI
10.1186/s12889-022-13390-8
language
English
LU publication?
no
additional info
© The Author(s) 2022.
id
30182d3b-bfc9-4e8d-ace6-fc65e768d23e
date added to LUP
2023-05-04 13:09:04
date last changed
2024-03-26 09:28:10
@article{30182d3b-bfc9-4e8d-ace6-fc65e768d23e,
  abstract     = {{Background<br/><br/>Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a major public health problem as patients can be infectious and also may develop a multi-drug resistant TB (MDR-TB). The study aimed to assess whether LTFU differs by the distance TB patients travelled to receive care from the nearest health facility.<br/>Methods<br/><br/>A total of 402 patient cards of TB patients who received care were reviewed from March 1–30, 2020. The Kaplan-Meir curve with the Log-rank test was used to compare differences in LTFU by the distance travelled to reach to the nearest health facility for TB care. The Cox proportional hazard regression model was used to identify predictors. All statistical tests are declared significant at a p-valueResults<br/><br/>A total of 37 patients were LTFU with the incidence rate of 11.26 per 1000 person-months of observations (PMOs) (95% CI: 8.15–15.53). The incidence rate ratio was 12.19 (95% CI: 5.01–35.73) among the groups compared (those who travelled 10 km or more versus those who travelled less than 10 km). Age ≥ 45 years (aHR = 7.71, 95% CI: 1.72, 34.50), educational status (primary schooling, aHR = 3.54, 95% CI: 1.49, 8.40; secondary schooling, aHR = 2.75, 95% CI: 1.08, 7.03), lack of family support (aHR = 2.80, 95% CI: 1.27, 6.19), nutritional support (aHR = 3.40, 95% CI:1.68, 6.89), ≥ 10 km distance to travel to a health facility (aHR = 6.06, 95% CI: 2.33, 15.81) had significantly predicted LTFU from TB treatment and care.<br/>Conclusions<br/><br/>LTFU from adult TB care and treatment was 12 times higher among those who travelled ≥10 km to reach a health facility compared to those who travelled less. To retain adult TB patients in care and ensure appropriate treatment, health professionals and other stakeholders should give due attention to the factors that drive LTFU. We suggest identifying concerns of older patients at admission and those who travel long distance and establish social support platforms that could help people to complete TB treatment.}},
  author       = {{Watumo, Desta and Merid Mengesha, Melkamu and Gobena, Tesfaye and Gebremichael, Mathewos Alemu and Jerene, Degu}},
  issn         = {{1471-2458}},
  keywords     = {{Loss to follow-up; Distance to health facility; Adults; Tuberculosis; Southern Ethiopia}},
  language     = {{eng}},
  month        = {{05}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Public Health}},
  title        = {{Predictors of loss to follow-up among adult tuberculosis patients in Southern Ethiopia : a retrospective follow-up study.}},
  url          = {{http://dx.doi.org/10.1186/s12889-022-13390-8}},
  doi          = {{10.1186/s12889-022-13390-8}},
  volume       = {{22}},
  year         = {{2022}},
}